| Glucagon-like peptide-1 (GLP-1) attenuates post-resuscitation myocardial microcirculatory dysfunction. | |
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MedLine Citation:
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PMID: 20347207 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM OF THE STUDY: Post-resuscitation syndrome leads to death in approximately 2 out of every 3 successfully resuscitated victims, and myocardial microcirculatory dysfunction is a major component of this syndrome. The aim of this study was to determine if glucagon-like peptide-1 (GLP-1) improves post-resuscitation myocardial microcirculatory function. METHODS: Ventricular fibrillation (VF) was induced electrically in 20 anesthetized domestic swine (30-35 kg). Following 8 min of untreated VF, animals were resuscitated with aggressive advanced cardiac life support (ACLS). Animals were blindly randomized to receive a continuous infusion of either GLP-1 (10 pM/kg/min) or equal volume saline as placebo (PBO) for 4h, beginning 1 min after return of spontaneous circulation (ROSC). Left ventricular (LV) haemodynamics, LV ejection fraction, cardiac output, and coronary flow reserve (CFR) [using a standard technique of intracoronary Doppler flow measurements before and after intracoronary administration of 60 microg adenosine] were performed pre-arrest and at 1 and 4h post-resuscitation. In the present study, CFR is a measure of myocardial microcirculatory function since these swine had no obstructive coronary artery disease. Twenty-four hour post-resuscitation survival and neurological functional scores were also determined. RESULTS: CFR was significantly increased in GLP-1-treated animals, 1h (1.79+/-0.13 in control animals vs. 2.05+/-0.12 in GLP-1-treated animals, P = <0.05) and 4h (1.82+/-0.16 in control animals vs. 2.31+/-0.13 in GLP-1-treated animals, P = <0.05) after ROSC. In addition, compared to PBO-treated animals, GLP-1 increased cardiac output 1h after ROSC (2.1+/-0.1 in control animals vs. 2.7+/-0.2 in GLP-1-treated animals, P = <0.05). There was no statistically significant difference in survival between GLP-1-treated (100%) and PBO-treated animals (78%). CONCLUSIONS: In this swine model of prolonged VF followed by successful resuscitation, myocardial microcirculatory function was enhanced with administration of GLP-1. However, GLP-1 treatment was not associated with a clinically significant improvement in post-resuscitation myocardial function. |
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Authors:
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Betsy B Dokken; W Ronald Hilwig; Mary K Teachey; R Ashish Panchal; Karl Hubner; Daniel Allen; David C Rogers; Karl B Kern |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-03-26 |
Journal Detail:
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Title: Resuscitation Volume: 81 ISSN: 1873-1570 ISO Abbreviation: Resuscitation Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-17 Completed Date: 2010-09-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 755-60 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Medicine, University of Arizona, Tucson, AZ, USA. bdokken@deptofmed.arizona.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Glucose / analysis Cardiac Output / drug effects Cardiopulmonary Resuscitation / adverse effects* Coronary Circulation / drug effects Coronary Disease / drug therapy*, etiology*, physiopathology Glucagon-Like Peptide 1 / administration & dosage* Heart / physiopathology Hemodynamics Humans Infusion Pumps Insulin / blood Lactic Acid / blood Microcirculation / drug effects* Nervous System / physiopathology Osmolar Concentration Survival Rate Swine Time Factors Ventricular Fibrillation / therapy* |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 11061-68-0/Insulin; 50-21-5/Lactic Acid; 89750-14-1/Glucagon-Like Peptide 1 |
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